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Shabbat Meals

Please fill out this form to reserve your place for a Friday evening or Shabbat lunch meal.
Full Name*
First NameLast Name
E-mail*
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Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
Area CodePhone Number
Please check one or both*
Friday evening mealShabbat lunch meal
Date(s) of reservation*
Number of Adults*
Number of Children*
Suggested donation amount is $54 per person. Please enter total amount you would like to donate.
Your donation will go towards the enrichment and growth of Jewish Life on Vancouver Island
Amount*
$
Currency*
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Payment

Credit Card

Credit Card Type
Credit Card Number
Name on Card
Expiration Month	Expiration Year

Please note reservation is only complete after receiving a follow up email.
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